LA JOLLA, Calif. — Injection of bupivacaine may correct strabismus via eye muscle alteration, with consistent and long-lasting results, according to a physician here.
“The effect of bupivacaine is not just to make the muscle bigger, which pulls the eye over, but it [also] makes it shorter and corrupts strabismus,” Alan B. Scott, MD, said at the American Ophthalmological Society meeting.
Alan B. Scott
The prospective pilot study included 31 patients with esotropic or exotropic strabismus. Nineteen patients with esotropia between 9 ∆D and 40 ∆D received a bupivacaine injection into the lateral rectus muscle, and 12 patients with exotropia between 12 ∆D and 85 ∆D received a bupivacaine injection into the medial rectus muscle.
Sixteen of the 31 patients with large strabismus angles also received a botulinum toxin injection into the antagonist muscle in the same treatment session.
The correction was 13 ∆D in 30 patients at 6 months, Scott said. In seven of the cases that received bupivacaine and botulinum toxin, the average correction was 19 ∆D.
Re-injections occurred in 25% of patients, and 40% experienced regression over a 2- to 4-year period; however, no vision loss or perforation occurred.
Disclosure: Scott has no relevant financial disclosures.